From the Guidelines
To diagnose Relative Energy Deficiency in Sport (RED-S), laboratory tests should include a complete blood count, electrolyte panel, and hormone profiles, such as follicle-stimulating hormone, luteinizing hormone, and estradiol levels in females, and testosterone levels in males 1. Additionally, markers of bone health, including vitamin D and parathyroid hormone, should be assessed. A fasting morning cortisol level and thyroid function tests, including thyroid-stimulating hormone and free thyroxine, may also be indicated to evaluate for potential endocrine abnormalities associated with RED-S 1.
Key Laboratory Tests
- Complete blood count
- Electrolyte panel
- Hormone profiles:
- Follicle-stimulating hormone
- Luteinizing hormone
- Estradiol (females)
- Testosterone (males)
- Markers of bone health:
- Vitamin D
- Parathyroid hormone
- Fasting morning cortisol level
- Thyroid function tests:
- Thyroid-stimulating hormone
- Free thyroxine
These laboratory tests can help identify the underlying causes of RED-S and guide treatment decisions 1. It is essential to consider the individual athlete's needs and medical history when selecting laboratory tests and interpreting results 1.
From the Research
Diagnostic Methods for Relative Energy Deficiency in Sport (RED-S)
The diagnosis of RED-S is challenging due to the nonspecificity and variety of symptoms. Key diagnostic methods include:
- Physical examination
- Anamnesis gaining
- Dual energy X-ray absorptiometry
- Bioimpedance body composition analysis
- Hormonal profile studies 2 Additional methods include:
- Electrocardiography
- Study of the basal metabolic rate
- Hematological examination (hemoglobin, ferritin, etc.)
- Determining the level of energy consumption using diaries of food and physical activity
- Determining blood vitamin level, etc. 2
Laboratory Tests for RED-S
Laboratory tests that may be indicated for RED-S include:
- Hematological examination (hemoglobin, ferritin, etc.) 2
- Hormonal profile studies (e.g. FSH, LH, testosterone, estrogen) 2, 3
- Dual energy X-ray absorptiometry (to assess bone mineral density) 2
- Bioimpedance body composition analysis (to assess body composition) 2 These tests can help identify the underlying energy deficiency and its effects on the body, as well as guide treatment and prevention strategies.
Clinical Protocols for RED-S
Clinical protocols, such as the RED-S CAT, can be used to screen, diagnose, and manage RED-S in athletes 4. These protocols typically involve a combination of medical and nutritional assessments, as well as monitoring of athlete health and performance.